How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,259 to $10,471Professionalmedian $1,995 · 10th to 90th $1,445 to $2,951
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $933.25 Median $1,905.46 Typical High $7,762.47 | Facility | None | $933.25 | $1,905.46 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,621.81 | $2,454.71 |
BCBS Illinois Setting Facility Modifier None Typical Low $4,786.30 Median $7,079.46 Typical High $22,908.68 | Facility | None | $4,786.30 | $7,079.46 | $22,908.68 |
BCBS Illinois Setting Professional Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,754.23 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $5,623.41 Typical High $7,244.36 | Facility | None | $776.25 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,778.28 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,318.26 | $2,089.30 | $4,265.80 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,698.24 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,090.30 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,949.84 | $3,162.28 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,148.15 | $1,148.15 |
Where Illinois sits
The same service costs 6.6 times more in Alabama than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AL $18,462KY $2,797
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.